Going to the hospital is traumatic at the best of times, when a person is alert and cognizant of all the obligations to complete paperwork and make sure that insurance companies have been duly notified and all procedures and treatments have been approved in advance and will be performed by in-network providers.

But when providers who are out-of-network muscle into the picture — a scenario that’s all too common these days, as agreements with insurers terminate, providers move from one system to another, are acquired in a consolidation or simply do not participate in whatever plan the patient is covered by — that picture changes, usually drastically.

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